Abstract
Objective
To investigate sexual functioning and its predictors in spouses/partners of persons
with traumatic brain injury (TBI).
Design
Inception cohort survey.
Setting
Community.
Participants
Persons (N=70) with complicated mild to severe TBI admitted to 1 of 6 participating
TBI Model Systems inpatient rehabilitation units and their spouses/partners who were
both living in the community and assessed 1 year after injury.
Interventions
Not applicable.
Main Outcome Measures
Derogatis Interview for Sexual Functioning Self-Report; Global Sexual Satisfaction
Index.
Results
Twenty percent of spouses/partners of persons with TBI reported sexual dysfunction,
and 44% reported dissatisfaction with sexual functioning. Sixty-two percent of spouses/partners
reported a decrease in sexual activity during the year postinjury, 34% reported a
decrease in sexual drive or desire, and 34% indicated that sexuality was less important
in comparison to preinjury. The sexual functioning of spouses/partners of persons
with TBI was highly associated with the sexual functioning of the person with TBI.
Age of spouses/partners and sexual functioning in persons with the TBI were significant
predictors of spouses'/partners' sexual functioning, even after controlling for sex
of partners and the physical, cognitive, participation, and sexual functioning of
the persons with injury.
Conclusions
Greater sexual dysfunction in spouses/partners was associated with older age and with
poorer sexual functioning in the person with injury. Rehabilitation professionals
should provide education on the potential impact of TBI on sexual functioning for
both persons with TBI and their spouses/partners, and integrate the assessment of
sexual functioning into their clinical assessment, making appropriate referrals for
therapy.
Keywords
List of abbreviations:
DISF-SR (Derogatis Interview for Sexual Functioning Self-Report), GCS (Glasgow Coma Scale), GSSI (Global Sexual Satisfaction Index), PART-O (Participation Assessment with Recombined Tools–Objective), TBI (traumatic brain injury), TBIMS (Traumatic Brain Injury Model Systems)To read this article in full you will need to make a payment
Purchase one-time access:
Academic and PersonalCorporate R&D ProfessionalsOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The relationship between neurobehavioral problems of severe traumatic brain injury (TBI), family functioning and the psychological well-being of the spouse/caregiver: path model analysis.Brain Inj. 2002; 16: 743-757
- Long-term adjustment of families following traumatic brain injury where comprehensive rehabilitation has been provided.Brain Inj. 2003; 17: 453-468
- Life satisfaction and distress in family caregivers as related to specific behavioural changes after traumatic brain injury.Brain Inj. 2005; 19: 1105-1115
- The impact of head injury neurobehavioural sequelae on personal relationships: preliminary findings.Brain Inj. 2005; 19: 845-851
- Rearranged marriages: marital relationships after head injury.Brain Inj. 1999; 13: 785-796
- Family burden following traumatic brain injury.Rehabil Psychol. 1994; 39: 29-48
- Patient correlates of caregiver's distress and family functioning after traumatic brain injury.Brain Inj. 1994; 8: 211-230
- Psychological distress and family satisfaction following traumatic brain injury: injured individuals and their primary, secondary, and tertiary carers.J Head Trauma Rehabil. 2000; 15: 909-929
- Marital adjustment and stability following traumatic brain injury: a pilot qualitative analysis of spouse perspectives.J Head Trauma Rehabil. 2011; 26: 69-78
- Change in relationship status following traumatic brain injury.Brain Inj. 1997; 11: 491-501
- Marital stability after brain injury: an investigation and analysis.NeuroRehabilitation. 2007; 22: 53-59
- A review of the effect of traumatic brain injury on the human sexual response.Brain Inj. 1999; 13: 269-280
- Sexual functioning one year following traumatic brain injury: findings from a prospective Traumatic Brain Injury Model Systems study.Arch Phys Med Rehabil. 2012; 93: 1331-1337
- Changes in sexual functioning from six to twelve months following traumatic brain injury: a prospective TBI Model System multicenter study.J Head Trauma Rehabil. 2013; 28: 179-185
- Sexuality among wounded veterans of Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND): implications for rehabilitation psychologists.Rehabil Psychol. 2011; 56: 289-301
- Sexual functioning and marital adjustment after traumatic brain injury.Arch Phys Med Rehabil. 1990; 5: 52-59
- Psychosexual and psychosocial sequelae of closed head injury.Brain Inj. 1991; 5: 303-313
- Exploring experiences of intimacy from the viewpoint of individuals with traumatic brain injury and their partners.J Head Trauma Rehabil. 2011; 26: 56-68
- Assessment of coma and impaired consciousness. A practical scale.Lancet. 1974; 2: 81-84
- Predictors of sexual functioning and satisfaction one year following traumatic brain injury: a TBI Model Systems multicenter study.J Head Trauma Rehabil. 2013; 28: 186-194
- The Derogatis Interview for Sexual Functioning (DISF/DISF-SR): an introductory report.J Sex Marital Ther. 1997; 23: 291-304
- Derogatis Interview for Sexual Functioning.Clinical Psychometric Research, Baltimore1987
- Pretreatment evaluation of sexual function in patients with adenocarcinoma of the prostate.Int J Radiat Oncol Biol Phys. 1990; 19: 1001-1004
- Pre and posttreatment evaluation of sexual function in patients with adenocarcinoma of the prostate.Int J Radiat Oncol Biol Phys. 1990; 19: 729-732
- Derogatis Sexual Functioning Inventory.Clinical Psychometrics, Baltimore1975
- Psychosexual consequences of traumatic brain injury: methodology and preliminary findings.Brain Inj. 1989; 3: 177-186
- Sexual changes associated with traumatic brain injury.Neuropsychol Rehabil. 2003; 13: 275-289
- Guide for the Uniform Data Set for Medical Rehabilitation (including the FIMTM instrument), version 5.1. State Univ of New York at Buffalo, Buffalo1997
- Characteristics and comparisons of functional assessment indices: Disability Rating Scale, Functional Independence Measure, and Functional Assessment Measure.J Head Trauma Rehabil. 1993; 8: 60-74
- The structure and stability of the Functional Independence Measure.Arch Phys Med Rehabil. 1994; 75: 127-132
- Functional outcome in children with traumatic brain injury. Agreement between clinical judgment and the Functional Independence Measure.Am J Phys Med Rehabil. 1992; 71: 145-148
- Interrater agreement of the seven-level Functional Independence Measure (FIM).Arch Phys Med Rehabil. 1991; 71: 790
- Prediction of rehabilitation outcomes with disability measures.Arch Phys Med Rehabil. 1994; 75: 133-143
- Comparison of scoring methods for the Participation Assessment with Recombined Tools–Objective.Arch Phys Med Rehabil. 2011; 92: 552-563
- Advancing the measurement of participation.Arch Phys Med Rehabil. 2011; 92: 540-541
- National Institute of Neurological Disorders and Stroke Common Data Element Project—approach and methods.Clin Trials. 2012; 9: 322-329
- Recommendations for the use of common outcome measures in traumatic brain injury research.Arch Phys Med Rehabil. 2010; 91 (e17): 1650-1660
- Statistical power analysis for the behavioral sciences.Lawrence Erlbaum Associates, Hillsdale1988
- The measurement of observer agreement for categorical data.Biometrics. 1977; 33: 159-174
- Sexual activity, sexual disorders and associated help-seeking behavior among mature adults in five Anglophone countries from the Global Survey of Sexual Attitudes and Behaviors (GSSAB).J Sex Marital Ther. 2006; 32: 331-342
- Sexual adjustment and its predictors after traumatic brain injury.Brain Inj. 1998; 12: 349-368
- Sexual dysfunction after traumatic brain injury.NeuroRehabilitation. 2000; 15: 107-120
- Sexual health and well-being among older men and women in England: findings from the English Longitudinal Study of Ageing.Arch Sex Behav. 2016; 45: 133-144
- Sexuality after traumatic brain injury.Arch Phys Med Rehabil. 2014; 95: 1801-1802
Article Info
Publication History
Published online: February 01, 2016
Footnotes
Supported by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant nos. 90DP0028, H133A070043, 90RT5007, H133A080044, H133A070042, 90DP0036). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this publication do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government.
Disclosures: none.
The NIDILRR Traumatic Brain Injury Model Systems Module Project on Sexuality After TBI was a collaborative effort between TIRR (principal investigator [PI]: Angelle M. Sander), Carolinas Rehabilitation Hospital (site PI: Flora M. Hammond), Craig Hospital (site PI: David Ripley), Mayo Clinic (site PI: Anne Moessner), Rehabilitation Institute of Chicago (site PI: Felise Zollman), and Wayne State University (site PI: Robin A. Hanks).
Identification
Copyright
© 2016 The American Congress of Rehabilitation Medicine.
